Individual
DR. LOUIS ERCOLANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 FRUIT ST, MASS GENERAL RENAL UNIT, BOSTON, MA 02114-2621
(617) 726-5050
(617) 724-1122
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIANS ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
51939
MA
207RN0300X
Nephrology Physician
Primary
51939
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051939
TUFTS HEALTH PLAN
MA
05
—
6171494
—
MA
01
—
J02728
BCBS MA
MA
Enumeration date
12/08/2005
Last updated
09/23/2011
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